{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:59:36Z","timestamp":1789664376207,"version":"4.0.1"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Planning &amp;amp; Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVAX was designed to support the discovery, development, and distribution of COVID\u201019 vaccines globally, at scale and pace. This article examines how COVAX promoted vaccine equity and what lessons can be learnt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Informed by a scoping review of lessons learnt from GHPs, we reviewed 109 documents related to COVAX and other GHPs and conducted 23 key informant interviews with representatives from GHPs, civil society, academia, and the private sector. Data were synthesised thematically using Rushton and Williams's framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data showed how the global health policy context shaped COVAX, with experience with Gavi and CEPI influencing its governance structure. We highlighted weaknesses in transparency and accountability, limited engagement with civil society organisations [CSO] and LMIC stakeholders, contested policy debates (e.g., different framing) and paradigms (e.g., prioritising technical and financial over political solutions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVAX largely replicated existing GHP approaches, subsidising research and development and then paying for resulting discoveries. While recognising how this reflects global power structures, in the inevitable next global health crisis, the international health community must advocate for greater LMIC and CSO involvement in decision\u2010making, sharing of intellectual property and technology transfer, and rebalancing of flows of innovation costs and benefits to a broader range of actors across public and private sectors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hpm.70028","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T05:19:10Z","timestamp":1759295950000},"page":"59-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["\u2018I Think From the Beginning, the Ambitions Were Compromised\u2019: A Case Study of COVAX as Vaccine Equity Policy Operationalisation"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4174-7349","authenticated-orcid":false,"given":"Charnele","family":"Nunes","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine (LSHTM) Faculty of Public Health and Policy  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-9683","authenticated-orcid":false,"given":"Martin","family":"Mckee","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine (LSHTM) Faculty of Public Health and Policy  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6105-9565","authenticated-orcid":false,"given":"Simon","family":"Rushton","sequence":"additional","affiliation":[{"name":"School of Sociological Studies Politics and International Relations University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1055-9871","authenticated-orcid":false,"given":"Natasha","family":"Howard","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine (LSHTM) Faculty of Public Health and Policy  London UK"},{"name":"Saw Swee Hock School of Public Health National University of Singapore and National University Health System  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Gavi \u201cAbout COVAX \u201d (2024) Accessed August 2024 https:\/\/www.gavi.org\/covax\/about#:~:text=A%20historic%20multilateral%20effort%20co to%20the%20COVID%2D19%20pandemic."},{"key":"e_1_2_11_3_1","unstructured":"S.Berkley \u201cCOVAX Explained. 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